a few words about work related developments, just bare with me.
a patient comes in last night complaining of face numbness. why is she in OB (that's labor and delivery, obstetrical) triage? because she has a vagina, and it just so happened that she, in some past, kind of recent past, delivered a baby...through her vagina. so what am I going to do about her face numbness? am i qualified to take care of neurological numbness issues? NOPE. but it doesnt matter. she has a vagina and has recently reproduced, therefore, she is now my responsibility. so what did i do? consulted neuro like the real downstairs ED would have done. they diagnosed and prescribed necessary meds and my job? was to periodically check on her to make sure she wasnt bored out of her mind waiting for the neurology resident.
so why are other services afraid of women? well, maybe not all women in general, but vaginas more specifically. dont get me wrong, i'm more than happy to see patients and take care of them when other services request help. but sometimes patients get send over and consulted on for reasons that are far from gynecological. case in point. my colleague had to see a consult in the ER for vaginal bleeding. she goes downstairs and meets a sweet little lady who found blood in her underwear. my coresident evaluates patient because vaginal bleeding in little old lady can only mean badness, only to find that the lady is having rectal bleeding...from her massive adn quite visible hemorrhoids. is this a gyne issue? no. did the ED resident even bother checking 'down there' to identify the source of blood? no. the lesson? not all that bleeds is gyne!
pregnancy kind of goes along the same lines. just because the lady is pregnant doesnt mean her complaints are pregnancy related. pregnant women are still humans. i know it's weird and strange and scary, but they are still women and patients, first adn foremost. so twisted ankles, headaches, diarrhea can still be treated like it would be in normal people...really. i promise. on the opposite spectrum, of course, are pregnant ladies themselves, who, in their pregnant state, suddenly become superalert and hypervigilant and every little minor thing becomes an emergency. i know, i've never been pregnant, but i imagine having a growing moving entity inside your abdomen must incite all sorts of weirdnesses, aches, and sensations (including gas and general bowel complaints). so is it really necessary to make a special trip to the ED if you're having a headache? or havent had a bowel movement in 2 days. 'do you otherwise feel ok? are you vomiting, are you still eating?" 'yeah, but i feel constipated.' but, wait, given my crazy broken schedule of residency, i'm constipated too! you dont find me hanging out in the ED in the middle of the night! (well, you do, but not as a patient) sigh. it's ok, dealing with all sorts of complaints will only make me a more educated health care provider. and i'm more than happy to reassure my patients that everything is ok. it just sucks that they end up waiting in triage for hours :(.
